Acupuncture for PTSD

Research

There are numerous studies which demonstrate that acupuncture can improve feelings of stress and anxiety, and physical symptoms related to traumatic events:

A 2007 study divided patients into 3 groups – an acupuncture, a cognitive behavioral therapy (CBT) group, and a “waiting list control” group (i.e. a group who received no treatment during the duration of the study), “to control for the natural history of PTSD in the recruited population”. PTSD symptoms were assessed before the study period, at the end of the study period, and then 3 months after the end of the study period.

• The study lasted for 12 weeks and the patients in the acupuncture group were given 2 treatments a week.
• the acupuncture points used were LR3, PC6, Ht7, ST36, SP6, and 印堂 YinTang, which is a point between the eyes. They then used numerous points on the back GB20, BL14, 15, 18, 20, 21 and 23. The needles were twisted once after insertion, and before removal.
• This protocol seems to me a little bit excessive, not least as every once in a while a needle can hurt a bit, and the researchers here used nearly 30 needles, 2x a week.
• Pressing points on the back makes much more sense, since it can often be just as effective as acupuncture, and also allows the patient to totally relax during the second part of the treatment, without any apprehension of discomfort from the needles.
• This study also used pressure points inside the ear. The names of the points were Shenmen 神門 “the Gate of the Spirit”, Sympathic Nervous System, Liver, Kidney, and Lung, and patients were asked to massage the seeds for 15 minutes a day.
• Again, 15 minutes seems a bit excessive. Chinese sources usually recommend just pressing them until there is a mild throbbing sensation at the point, and that really doesn’t take as long as 15 minutes.

An 2011 study of 91 earthquake survivors in China showed that acupuncture with cognitive behavioral therapy (CBT) was more effective than just CBT alone in relieving PTSD symptoms.

• like the 2019 study below, this study used electrical stimulation of acupuncture points, and a very interesting and unusual point selection, consisting of only one point – the point is in the palm of the hand and is called in PC (pericardium) 8. One can only get away with this kind of thing in China, as this point is pretty painful to use, even without electrical stimulation !
• However, a little further up the arm is a less painful point along the same “meridian” or acupuncture line, which is the same one used in 2022 paper cited below and published in Nature – this point is called PC-6. Probably the reason that points on the Pericardium meridian were chosen is because the Heart / Pericardium is associated with memory in traditional Chinese Medicine Theory ♥️

A 2019 study on survivors of a large earthquake in Italy showed that acupuncture improved mental and physical symptoms associated with this traumatic event. The study found that 54% of patients had marked improvements in the psychological symptoms (anxiety, depression, insomnia, etc.) and 60% had marked improvements in pain symptoms.

• The study lasted for 5 weeks
• the points were selected from the Kidney, Large Intestine, Spleen and Gallbladder meridians, according to individual diagnoses made for each patient. This is excellent clinical practice, but it does it make it difficult to generalise research results.
• after only 3 treatments (albeit administered on 3 consecutive days) patients reported 50% and 60% improvement in psychological and physical symptoms respectively.

Another 2019 study found that electrical acupoint stimulation in addition to sertraline or cognitive behavioral therapy (CBT) enhanced treatment of PTSD symptoms. The groups that used electrical acupoint stimulation as part of their treatment plan had marked improvements in PTSD symptoms versus the groups that did not use it. This was an interesting protocol, chosen because the authors thought electrical stimulation was less invasive than traditional acupuncture, but the problem is, outside of a research setting, very few people possess the requisite electrical equipment.

This not-very-easy-to-read study is nonetheless particularly interesting , being very recent (2022), and moreover having been published in Nature, which is probably the most respected scientific journal in the world.

• According to the authors, acupuncture and Chinese Medicine are especially appropriate for the treatment of PTSD, because dissociation and separation between the mind and the body is a key feature of the disorder (citing McFarlane 2017), and the unity of mind and body is a cornerstone of Chinese Medicine theory.
• the MacFarlance paper (short and not-very-difficult-to-read) begins by criticising the “Cartesian duality” of mind and body (which does not exist in Chinese Medicine) as being responsible for many of the misunderstandings and lacunae in psychiatry in general, but in PTSD in particular, stating that “biological dysregulation [is] inherent to this disorder, a factor not systemically addressed by current treatments”

Memory in Chinese Medicine

The NHS says this about PTSD :

Someone with PTSD often relives the traumatic event through nightmares and flashbacks, and may experience feelings of isolation, irritability and guilt.

How do we relive past events? Through memory, whether awake or in dreams. Since Chinese Medicine eschews the” Cartesian duality ” of body and mind, which is a horrendously complicated way of saying that we think the mind and body are a continuum, and not really two separate things, the way that we treat memory disorders is physical. We (like Freud’s student, Wilhem Reich, who inspired Somatic Experiencing) think that memory is “stored” in the body as well as the mind, and actually, we more often access and manipulate it through the body than through the mind, since Chinese Medicine, maybe for cultural reasons, does not exactly have a psychiatric specialism which depends on “talking therapies”.

So if we think that memory is physical, where in the physical form do we think it resides? Generally speaking, in Chinese Medicine, memory depends on the Heart. Like the ancient Romans and Greeks, the ancient Chinese thought the mind resided in the middle of the chest. No doubt this is strange to our brain-focused culture, but nonetheless, this is what they believed. Whether this is anatomically correct or not does not really matter for our purposes.

And what do we do about it?

Muscular Armouring

coming soon !